Seniors, Sex, and STDs

Blame Viagra, or just the fact that Americans are living longer, healthier lives. For many reasons, sexually transmitted diseases (more accurately referred to as sexually transmitted infections, or STIs, because it's possible to be infected without developing any signs or symptoms) are rising among older adults, with potentially serious health consequences.

The Centers for Disease Control and Prevention (CDC) reports significant increases in STDs between 2010 and 2014 among adults 65 and over:

Chlamydia infections increased by about 52 percent

Syphilis infections rose by about 65 percent

Gonorrhea cases increased by more than 90 percent

In sheer numbers, young adults ages 20-24 still hold the STD heavyweight title by far. They contracted about 686,722 million cases of those three STDs in 2014, compared with 2,616 cases among people 65 and older.

Another way of looking at it: Seniors had a fraction—far less than 1 percent—of the number of STDs that young adults did.

Still, the increases concern health officials because STDs were rare among seniors in the past. And as reports about STDs in older people made headlines over the past few years, seniors also woke up to the risk. The Department of Health and Human Services notes that 2.2 million Medicare beneficiaries received free STD screenings and counseling sessions in 2011 and 2012—about the same number that got colonoscopies. And more than 66,000 received free HIV tests. Disturbingly, 27 percent of new AIDS diagnoses in the US in 2013 were among people age 50 or older.

What’s causing the increase?

Well, for one thing, Americans are living longer in better health. As a result, more are remaining sexually active well into the golden years. About 53 percent of people over 65 say they are sexually active, and a quarter of those over 75 say they still have sex, according to a survey published in the New England Journal of Medicine. For those who need an assist, there are drugs such as Viagra and Cialis to help a man get and keep an erection.

There are also more divorced older people than there were in past decades. Couples over 65 were more than twice as likely to go through a divorce in 2014 than they were in the 1990s. So more are on the dating market.

Also, older baby boomers came of age when birth control pills were widely accepted; they are not a generation raised on condoms. Sexually active older adults have the lowest rate of condom use compared to all other age groups, according to the 2010 National Survey of Sexual Health and Behavior.

Part of the STD problem among seniors may also have to do with past societal expectations that older people don’t have—or want to talk about—sex: In a New England Journal of Medicine survey, only 22 percent of women and 38 percent of men said they’d talked about sex with their doctor since they’d turned 50. And doctors might not routinely ask questions about a senior’s sex life during exams. That silence may be a particular problem for women. The vaginal lining thins after menopause, which can make older women even more vulnerable to infections than younger women.

Getting the word out on safe sex for seniors

The CDC and other organizations such as Safer Sex for Seniors are working to raise awareness of STDs among older adults. The message: Keep condoms handy, whatever your age. It’s a small price to pay for the assurance that sex—safer sex—can keep going long after that AARP card comes the mail.